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CERTI

FICATEOFMEDI
CALFI
TNESS

Tobeobt ai
nedonlyfrom aGazet
tedGovernmentMedical
Offi
cer/Medical
Offi
cerofa
GovernmentUndertaki
ng.Pl
easenotethatthi
scer
ti
fi
cateinnootherf
orm wil
lbeaccept
ed.
MedicalCert
if
icat
esissuedbypri
vatemedicalpr
acti
ti
onerswil
lnotbeaccept
ed.

(
pleaser
efert
opr
escr
ibedst
andar
dsgi
venov
erl
eaf
)

Name(
inBl
ockl
ett
ers) : _
___
___
___
___
___
___
___
___
___
___
___
_

Fat
her
’sName : _
___
___
___
___
___
___
___
___
___
___
___
_

Hei
ght:
___
___
___
___
___
___
___
___
Wei
ght
:__
___
___
___
___
___
___
___

Bl
oodGr
oup&Rh.Fact
or_
___
___
___
___
___
___
___
___
___
_Chest
:__
___
___
___
___
_

Hear
t&Lungs:
___
___
___
___
___
___
___
___
___
___
___
___
___
___
___

Vi
sion:
L:_
___
___
___
_ R:
___
___
___
___
___
___
___
___
__

Col
ourVi
sion:
___
___
___
___
___
___
___
___
___
___
___
___
___
___
___
_

Hear
ing:
___
___
___
___
___
___
___
___

Her
nia/Hy
drocel
e/Pi
l
es:
___
___
___
___
___
___
___
___
___
___
___
___
_

Remar
ks:
___
___
___
___
___
___
___
___
___
___
___
___
___
___
___
___
___
___
___
___
___
___
___

Icer
ti
fyt
hatIhav
ecar
eful
l
yexami
nedSh./Km.
/Sm._
___
___
___
___
___
___
_

Son/daughterofSh._____
___
_____
___
__,whohassi
gnedi
nmypr
esence.He/Shehasno
ment
alandphysi
cal
diseaseandisFI
T.

Si
gnat
ureoft
heCandi
dat
e

Si
gnat
ureoft
heMedi
calOf
fi
cer

Wi
thl
egi
bleseal

St
ati
on:
___
___
___
__

Dat
e: _
___
___
___
__

(
Forpr
escr
ibedMedi
calSt
andar
dsf
oradmi
ssi
onseenextpage)
Pr
escr
ibedMedi
calSt
andar
dsf
orAdmi
ssi
on

Techni
calEducati
ondemandsgoodphy si
queandstamina.Anappli
cantwhosuf f
ersfrom any
organi
cdefectordoesnothavesoundheal
thsoastobearthestr
ainofthecoursewhichmust
beheight
enedinhis/herpr
ofessi
onall
i
fewouldbewelladvi
sednottotakeupt heEngineer
ing
/ManagementProfessi
on.He/Shemustful
fi
ll
thef
oll
owingmedicalst
andards.

Hei
ght : Notl
esst
han1.
5met
erf
ormal
ecandi
dat
es,
andnot

l
esst
han1.
2met
erf
orf
emal
ecandi
dat
es.

Wei
ght : 41Kg.appr
oxi
mat
elyf
ormal
ecandi
dat
esand37

kg.appr
oxi
mat
elyf
orf
emal
ecandi
dat
es.

Chestmeasur
ement : Notl
esst
han69cmswi
thsat
isf
act
oryl
i
mitof

expansi
onandcont
ract
ionf
ormal
ecandi
dat
esonl
y.

Hear
t&Lungs : Noabnor
mal
i
ty.

Har
nia,
Hydr
ocel
e : Pr
esenceoft
hesei
sat
empor
arydi
squal
i
ficat
iont
obe

&r
ect
if
iedbef
orej
oini
ngt
hecour
seofst
udy

Vi
sion : Normal,
wher edefect
ive,i
tshouldbecorrect
edto6/9
i
nt hebettereyeand6/ 12int hewor seeye.Eyeshoul
dbef ree
fr
om congenitalandotherdisease.I
nadditi
on,t
hepersonshould
notbecolourbli
nd.

Hear
ing : Nor
mal
,wher
edef
ect
ive,
itmustbecor
rect
ed.

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